gold sodium thiomalate (Discontinued)

Action and Spectrum

Actions and Spectrum: 

• gold sodium thiomalate is a gold-containing compound that has been used for the treatment of rheumatoid arthritis. Its actions and spectrum include: 
• Anti-inflammatory action: gold sodium thiomalate has potent anti-inflammatory effects, which help to reduce the inflammation and pain associated with rheumatoid arthritis. 
• Immunosuppressive action: The drug can also suppress the immune system, which is overactive in rheumatoid arthritis. By dampening the immune response, gold sodium thiomalate can help reduce joint damage caused by autoimmune disease. 
• Disease-modifying action: gold sodium thiomalate has disease-modifying properties, which can help slow the progression of rheumatoid arthritis and prevent joint damage over time. 
• Limited spectrum: gold sodium thiomalate has a limited spectrum of activity and is only effective in treating rheumatoid arthritis. It is not used to treat other forms of arthritis or inflammatory conditions. 

Drug Interaction

Adverse Reaction

Frequency defined 

>10% 

Diarrhea 

Pruritis 

Rash 

Proteinuria 

1-10% 

Leukopenia 

Thrombocytopenia 

Frequency not defined 

Aplastic Anemia 

Agranulocytes 

Enterocolitis 

Exfoliative dermatitis 

Liver failure 

Nephropathy 

Anaphylactoid reaction 

Corneal gold deposits 

Black Box Warning

Black Box Warning: 

The RMP should know the fatal and severe toxicities of chrysotherapy. 

It is essential to explain to the patients about the adverse reactions and their self-reporting by the patients. 

Check through the signs of toxicity of gold. 

The medication should be reserved for patients with active rheumatoid arthritis. 

Contraindication / Caution

Contraindication/Caution: 

gold sodium thiomalate has several contraindications and precautions that must be considered before use. These include:  

Precautions: 

• Hypersensitivity: gold sodium thiomalate is contraindicated in patients with known hypersensitivity to the drug or other gold compounds. Hypersensitivity reactions can range from mild skin rash to severe anaphylaxis. 
• Blood disorders: The drug is contraindicated in patients with blood disorders such as anemia, leukopenia, and thrombocytopenia, as it can exacerbate these conditions. 
• Kidney and liver disorders: gold sodium thiomalate is contraindicated in patients with severe kidney or liver disorders as it can worsen the condition. 
• Immunocompromised patients: The drug should be used cautiously in immunocompromised patients, as it can increase the risk of infections. 
• Skin disorders: Patients with psoriasis, eczema, or other skin disorders may be more prone to side effects from gold sodium thiomalate, and caution should be exercised. 
• Concomitant medications: The use of gold sodium thiomalate should be avoided in patients taking other medications that can cause liver damage, such as methotrexate. 

Pregnancy / Lactation

Pregnancy consideration:  

Category C 

Breastfeeding warnings:  

Lactation is not advised during the medication as it enters the breast milk. 

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: No evidence of risk to the fetus is found in animal reproduction studies, and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a human product; Pregnant women must take care of the potential risks. 
• Category D: There is adequate data with sufficient evidence of human fetal risk from various platforms. However, despite potential dangers may be used only in emergencies for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. The drug is not for pregnant women. 
• Category N: No data for the drug under this category is available. 

Pharmacology

Pharmacology: 

gold sodium thiomalate is a gold-containing compound that has been used for the treatment of rheumatoid arthritis (RA). The exact mechanism of action of gold sodium thiomalate is not fully understood, but it is believed to have immunomodulatory and anti-inflammatory effects. 

gold sodium thiomalate is thought to inhibit the production of inflammatory cytokines. 

gold sodium thiomalate also affects connective tissue metabolism, including cartilage and bone. It may help to reduce joint destruction and improve joint function in patients with RA. 

Pharmacodynamics: 

The pharmacodynamics of gold sodium thiomalate involves its ability to inhibit enzymes involved in the immune response, such as protein kinase C and lipoxygenase. This inhibition reduces the production of inflammatory cytokines, such as interleukin-1 and tumor necrosis factor. 

gold sodium thiomalate has also been shown to affect the activity of T-cells and B-cells, which play essential roles in the immune response. It appears to reduce the activity of T-helper cells and B-cells while increasing the activity of regulatory T-cells, which can help to prevent excessive inflammation and immune system activation. 

Pharmacokinetics: 

The onset of action takes place in 2-6 months 

The high amount of protein is bound 

The half-life is 6-25 days 

60-90% of the drug is excreted in urine and 10-40% in feces 

Adminstartion

Administration: 

gold sodium thiomalate is typically administered by intramuscular injection, usually into the buttock or thigh. The dose and frequency of administration may vary depending on the patient’s condition, but it is generally given once a week. 

Before starting treatment with gold sodium thiomalate, the patient should be screened for any contraindications or risk factors, such as a history of allergic reactions to gold compounds, kidney or liver disease, or blood disorders. 

After the injection, the patient may be monitored briefly to check for adverse reactions. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: gold sodium thiomalate  

Pronounced: gold-SOW-dee-um-thye-oh-MAL-ate 

Why do we use gold sodium thiomalate? 

gold sodium thiomalate treats certain autoimmune diseases, such as rheumatoid arthritis. It reduces inflammation and suppresses the immune system, which can help relieve symptoms such as joint pain and swelling. 

Although the exact mechanism of action of gold sodium thiomalate is not fully understood, it is thought to work by inhibiting enzymes involved in the immune response and reducing the production of inflammatory cytokines.  

It is typically part of a comprehensive treatment plan, including other medications, physical therapy, and lifestyle changes.